The Degree of Masculine Differentiation of Obesities

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Abstract
The obesities are distinguished from each other essentially by the degree of protein anabolism, that is, muscle-blood anabolism, which is associated with adipose hyperanabolism. Anthropometry demonstrates that the degree of this muscle-blood anabolism is greater in proportion to the predominance of fat over the upper part of the body, a characteristic linked to others which indicate the degree of masculine differentiation in both sexes. The calculation of an index of masculine differentiation (which is described) enables one to distinguish android and gynoid obesities and their intermediate forms. Gynoid obesity, with lower body predominance, with poor muscle-blood development, is menaced only by direct mechanical complications of excessive adiposity: locomotor difficulty, abdominal pressure, limitation of respiratory motion, slowing of the venous and lymphatic circulation, cellulitis, lowering of energy, and reduction of the elasticity of the fat-infiltrated myocardium—complications which are all proportional to the degree of excess fat. Android obesity, with upper body predominance and pronounced muscle-blood development, leads to metabolic disturbances. It not only is associated with premature atherosclerosis and diabetes, but it is also the usual cause of diabetes in the adult in 80 to 90 per cent of the cases. Gout and uric calculous disease generally appear in this form of obesity. Overactivity of the pituitary-adrenal axis appears to be the most probable cause both of android obesity and its complications.